POS0366 SEXUAL DYSFUNCTION IN SPONDYLOARTHRITIS PATIENTS: DIFFERENCES BETWEEN MALES AND FEMALES PATIENTS IN A REAL-WORLD SETTING
Authors: I. Pantano, D. Mauro, L. Napolitano, M. S. Ciliento, M. Visconti, F. Ciccia
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> In the field of rheumatology in general and in the context of spondylarthritis (SpA) more specifically, gender medicine is gaining more recognition and relevance. Available data suggest female patients feature higher diagnostic deladelayspared to males. Furthermore, female SpA patients experience higher disease activity, lower response rates to treatment and, less probability to achieve remission. Sexual dysfunctions are an aspect little investigated in SpA. Disease features and disease activity are known to influence sexual health. Conversely, little is known about the difference existing in sexual satisfaction in males and females affected by SpA. <h3>Objectives</h3> To investigate the sexual function and satisfaction in female and male patients affected by SpA and identify gender-specific features. <h3>Methods</h3> We conducted a cross-sectional study enrolling consecutive SpA patients satisfying ASAS criteria attending the SpA clinic of a tertiary university rheumatology clinic. Demographic and clinical characteristics were collected alongside with validated gender-specific questionnaire for the evaluation of sexual function. For male assessment, we used the international index of erectile function (IIEF) and the Premature Ejaculation Diagnostic Tool (PEDT); whereas in women we used The Female Sexual Function Index (FSFI) that explores domains such as desire, arousal, lubrification, orgasm, satisfaction, and pain. To evaluate the correlation between the presence of sexual dysfunction and disease characteristics or therapies we used the Spearman test and the univariate and multivariate tests. <h3>Results</h3> 73 males and 64 females were recruited, and the two groups were comparable with similar mean age, BMI, and disease duration (patients' characteristics are shown in table 1). PEDT test showed that 9.5% (5 male patients) had probable premature ejaculation and 15% (8 male patients) had premature ejaculation. According to IIEF sexual dysfunction was present in 19.4% of cases as mild dysfunction in 15.5% as moderate dysfunction and in 5.4% as severe dysfunction. Univariate and multivariate analysis showed a correlation between sexual dysfunction and mood disorders and premature ejaculation in men (p=0.02). The prevalence of premature ejaculation was not influenced by disease characteristics or activity or therapies. Sexual dysfunction in males was associated only with the use of NSAID (p=0.04). Evaluating the female group, FSFI showed that 85% (54 female patients) had sexual dysfunction. In the univariate and multivariate analysis, we found correlations between age (p=0.07), mood disorders (p=0.04), dyslipidemia (p=0.006), and BASDAI (p=0.04). Fibromyalgia was detected only in women. <h3>Conclusion</h3> This data demonstrates that sexual function is impaired in an extremely high percentage of female SpA patients, which contributes to the higher burden of SpA on women. Sexuality is still a little explored topic in SpA, despite is a relevant aspect of quality of life and determinant of psychological health. Therefore, it is necessary to thoroughly investigate the impact that the disease and comorbidities have on the sexual life of these patients with a particular focus on females. <h3>Reference</h3> [1]Gender Differences in Axial Spondyloarthritis: Women Are Not So Lucky. Rusman T, van Vollenhoven RF, van der Horst-Bruinsma IE.Curr Rheumatol Rep. 2018 May 12;20(6):35. doi: 10.1007/s11926-018-0744-2. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.